الفهرس 
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Abstract
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The prevalence of cirrhosis has nearly doubled over the last decade, and the number of hospitalizations has similarly increased.
Liver cirrhosis has a high impact on public healthcare, as it represents an important cause of mortality worldwide. Cardiac complications are not rare during decompensated liver cirrhosis. These complications include diastolic and systolic dysfunction as well as cardiac electrophysiological remodeling (known as cirrhotic cardiomyopathy). Cardiac complications of liver cirrhosis are typically the result of medications, hemodynamic disorders, infections, inflammatory states, and other unknown factors.
Some patients with liver cirrhosis develop a progressive cardiac dysfunction. This condition is named cirrhotic cardiomyopathy, and consists of an impaired ventricular performance to different stressful condition. It may not be clinically significant at rest because of the high cardiac output and low systemic vascular resistance, both which are present in late stages of liver cirrhosis.
Cirrhotic cardiomyopathy may have a prevalence of up to 60%. It is present in both adult and pediatric patients with cirrhosis and a major cause for morbidity and mortality.
A better understanding of pathophysiology and molecular targets will help guide the development of drug therapy for cirrhotic cardiomyopathy.
Aim of work:
The aim of work of the current study was to correlate between the severity of liver cirrhosis using the new MELD score and left ventricle diastolic dysfunction using tissue Doppler imaging. To elucidate this aim, 90 cases were included in the current study.
Results of the study:
In the studied group, the mean age was 53.13±9.44 years with males constituting more than half of them (57.8%). The mean MELD score was 24.08±6.01, and the mean left ventricular ejection fraction (LVEF %) was 60.43±5.49%.
There were 5 patients (5.6%) with normal LV diastolic function and 85 patients (94.4%) with abnormal LV diastolic dysfunction.
Out of the 90 patients, 5 patients were normal, 44 patients (48.9%) had a grade I LVDD, 28 patients (31.1%) had a grade II LVDD and 13 patients (14.4%) had a grade III LVDD.
There was a highly statistically significant positive association between the grades of left ventricular diastolic dysfunction according to ALT, AST, T.Bilirubin, D.Bilirubin, INR and Creatinine. Additionally, there was a highly statistically significant negative association between grading of left ventricular diastolic dysfunction according to platelet count and sodium levels.
The current study showed a highly statistically significant positive association between the grading of left ventricular diastolic dysfunction and the new MELD score.
There was a highly statistically significant positive association between the grade of left ventricular diastolic dysfunction according to MV E(m/s), MV E/A ratio, MV E/E’ ratio, TR velocity (m/s) and LAVI (LA volume/ BSA) (ml/m2).
There was a statistically significant higher mean of T.Bilirubin, D.Bilirubin, INR and Creatinine in the group with abnormal left ventricular diastolic function compared to the normal group.
Additionally, there was a statistically significant lower mean of sodium in the abnormal left ventricular diastolic function group compared to the normal group.
There was a highly statistically significant difference between normal and abnormal left ventricular diastolic function groups according to the new MELD score.
There was a highly statistically significant higher mean of abnormal left ventricular diastolic function group compared to normal group according to MV E(m/s), MV E/A ratio, MV E/E’ ratio, TR velocity (m/s) and LAVI (LA volume/ BSA) (ml/m2).
There were a highly statistically significant positive correlation between the new MELD score and the grade of left ventricular diastolic dysfunction.